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Midterm results following revision surgery in clubfeet

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Abstract

Relapse rates of surgically treated clubfeet are about 25%. We reviewed 43 patients (57 feet) treated for relapsed clubfoot deformity between 1992 and 2001 in our department. The average age of the patients at the time of revision surgery was 5.1 years, the mean follow-up was 6.6 years. Surgical therapy was performed using an algorithm according to age groups. The mean Atar score at follow-up was 77 points, representing a good outcome. Out of 57 feet, 20 (35%) were rated excellent, 24 (42%) good, 5 (9%) fair, and 8 (14%) poor. The number of previous surgical interventions had no influence on the outcome. Using an age related surgical algorithm, good postoperative results could be achieved in most of our patients, thus improving their functional situation. This emphasises the usefulness of the proposed algorithm in the difficult situation of recurrent clubfoot, while thorough analysis of the underlying deformity remains essential.

Résumé

Les récidives après traitement chirurgical des pieds bots sont relativement fréquentes aux alentours de 25%. Nous avons vu 43 patients (57 pieds) traités pour récidive de la déformation entre 1992 et 2001. L’âge moyen des patients à la révision était de 5.1 ans, le suivi moyen de 6.6 ans. Le traitement chirurgical a été réalisé selon un algorithme prenant en compte l’âge. Le score moyen d’Atar a été de 77 points, avec une bonne évolution clinique. Sur 57 pieds, 20 (35%) ont été considérés comme excellents, 24 (42%) bons, 5 (9%) comme moyens et 8 (14%) comme mauvais. Le nombre d’interventions chirurgicales utilisé réalisées n’influence pas le devenir du pied. L’algorithme selon l’âge a été utilisé pour la plupart des patients de façon à améliorer le résultat fonctionnel. Ceci nous conforte dans l’utilisation de cet algorithme dans les situations difficiles de récidives de pieds bots. Malgré tout cela, l’analyse des déformations reste essentielle.

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Authors and Affiliations

  1. Department of Orthopaedics, Julius-Maximilians University Wuerzburg, Brettreichstraße 11, 97074, Wuerzburg, Germany

    V. Ettl & P. Raab

  2. Department of Orthopaedics, Universitätsklinikum Carl Gustav Carus, Fetscherstr. 74, 01307, Dresden, Germany

    S. Kirschner

  3. Department of Orthopaedics, Heinrich-Heine University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany

    R. Krauspe

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  1. V. Ettl
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  2. S. Kirschner
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  3. R. Krauspe
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  4. P. Raab
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Correspondence to P. Raab.

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Ettl, V., Kirschner, S., Krauspe, R. et al. Midterm results following revision surgery in clubfeet. International Orthopaedics (SICOT) 33, 515–520 (2009). https://doi.org/10.1007/s00264-007-0495-6

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  • DOI: https://doi.org/10.1007/s00264-007-0495-6

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